SHINE
Serving the Health Insurance Needs of Everyone

Implementation Council Meeting

April 25, 2014

Slide 2: Massachusetts SHINE By the Numbers

  • 4.0 FTE at state level including new Project Coordinator who will perform Latino and One Care outreach and education among other duties
  • 13 regional programs and Greater Boston Chinese Golden Age Center
  • About 550 counselors in community based organizations - municipal and community centers, independent living centers (ILC), hospitals, housing
  • 78 bilingual counselors
  • 64,068 client contacts – 22% under 65, 9.5% with Social Security disability (2013 data)
  • 715 of 1555 presentations/health fairs/newsletters in 2013 for people who have disabilities

Slide 3: SHINE Training

  • 48 hours of initial training; certified to provide one-to-one health benefits counseling
  • Training includes Medicare, MassHealth, medicare.gov, internet, provider web sites, pharmacy benefits, and cultural competency
  • Monthly training on One Care enrollment, mailings, reports
  • Collect CMS-required data, analyze and returned to state– goal is to improve program performance

Slide 4: Counseling sessions

  • Counseling can be:
  • Face-to-face, in accessible locations
  • By phone, or via email
  • Topics can include:
  • Medicare and Medicaid eligibility,
  • Prescription drug lists and pharmacy of choice,
  • Provider lists,
  • One Care services vs. current services,
  • Information about the ability to opt out of One Care,
  • Options to consider as displayed on medicare.gov
  • Next steps may include: discussion with the consumers’ provider, family members, a One Care plan, a call to MassHealth, and/or a follow-up appointment

Slide 5: Pre-enrollment Form

  • Used to collect list of medications and providers, zip code to check county availability
  • Use medicare.gov, plan web sites, call plans to confirm providers contracted and medication list
  • Counselor reminds that plans can contract on an individual basis if not on list
  • Counselors have no additional information to use than that provided by individual and these web sites

Slide 6:One Care Client contacts by Regional SHINE Office*

  • Elder Services – Berkshire, Franklin and Hampshire County
  • 16 contacts
  • Franklin Co Home Care – Franklin and Hampshire County
  • 71 contacts
  • Springfield Dept Elder – Hampden County
  • 43 contacts
  • Milford Senior Center – Worcester
  • 221 contacts
  • Mystic Valley – Middlesex
  • 69 contacts
  • HESSCO – Norfolk
  • 220 contacts
  • Elder Services Merrimack – Essex, Middlesex
  • 53 contacts
  • Metrowest – Middlesex, Norfolk, Worcester
  • 105 contacts
  • Ethos, Chinese Golden – Suffolk
  • 105 contacts
  • Middleboro – Plymouth
  • 62 contacts
  • Minuteman – Middlesex, Worcester
  • 67 contacts
  • Total posted = 1032

Slide 7: Disposition by Choice

  • Opted out of One Care – 250
  • Enrolled in Plan Other than One Assigned – 21
  • Actively enrolled in Plan of Their Choice – 41
  • Remained in Assigned Plan – 30
  • Decision in Progreess – 690
  • Total – 1032

Slide 8: Spreading the Word About One Care

  • Spring 2014-train ADRC counselors and agency staff who are working with the consumers
  • Spring/summer -educate beneficiaries, consumers and caregivers via presentations
  • Provide visibility via cable TV, material dissemination, newsletter articles, social media
  • Educate professionals via training and workshops for medical and community agency staff, etc. (CEUs for social workers)
  • Developing Latino and Chinese outreach plans
  • Maintain availability via phone, face-to-face, and email Monday through-Friday, 9 am to 5 pm

Slide 9: Coordination with Partners

Since October met with and discussed:

  • Options Counselors- ILCs, ASAPs
  • Senior Medicare Patrol Project
  • North Shore Elder Law Attorneys
  • NAMI regional group
  • Multicultural Coalition, Boston
  • Boston Medical Center cancer support group
  • Disparities Coalition, Boston
  • Veterans Service Officers conference
  • Mayor’s Long Term Care Task Force

Slide 10: More

  • Pharmacist conference at Gillette Stadium, chain pharmacy reps
  • MassHome Care conference
  • Mass Councils on Aging conference
  • Table at Community Health worker conference
  • Hopefully LBGT conference
  • Abilities Expo
  • 9 upcoming Social Security events
  • We want to work with you. Invite us and we will come!

Slide 11: SHINE Provides Referrals for Information, Counseling, and Presentations

  • Call: 1-800-243-4636, press 3 to get referrals to and information about:
  • MassHealth and One Care Plans,
  • Health insurance options
  • Location of nearest SHINE counselor
  • One Care website:
  • Elder Affairs web portal:

Slide 12: Questions